Knoxville Medicine Winter 2016 by Knoxville Academy of Medicine

Volum e L X X III, No . 4 â&#x20AC;¢ W in te r 2 0 1 6

Se r ving the Gr e ate r M e tr opolitan Knoxvi l l e Area

KAM HOLIDAY SPECIAL ISSUE ACADEMY NEWS LEGISLATIVE UPDATE PLUS-KEENELAND, ANNUAL LEGISLATIVE DINNER, & LMU-DEBUSK COLLEGE OF MEDICINE STUDENTS JOIN KAM

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Friday, April 7, 2017 6:30 pm Knoxville Marriott

KAPA’s Boot Scootin’ Ball is quickly becoming one of Knoxville’s most talked about charity events. The evening will be packed with great country music by THE CHARLIE DANIELS BAND, line dancing, signature drinks, a stick to your bones mouth-watering western-themed dinner, and a variety of beers in your own bottomless souvenir glass. A large silent auction will complete this special event with all of the proceeds to benefit Knoxville Area Project Access (KAPA). The Boot Scootin’ Ball is a high-end event that requires casual attire--what could be better than that? For more info & tickets visit kapabootscootin.com or call (865) 531-2766

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Academy Officers

PRESIDENT’S MESSAGE By: Thomas Pollard, MD

Thomas Pollard, MD PRESIDENT

Neil Coleman, MD PRESIDENT ELECT

Ceeccy Yang, MD SECRETARY

Tim Wilson, MD TREASURER

Pat O’Brien, MD

IMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees Clif Tennison, MD Jeff Ollis, MD David Harris, MD Michael Brunson, MD Daniel Bustamante, MD

Ex- Officio Board Members Randal Dabbs, MD Elise Denneny, MD Richard DePersio, MD Jerry Epps, MD Robert Page, MD Lorraine Johnson -KAMA

Publisher Kim Weaver, PhD

Editor Jonathan Weaver

Production Coordinator Margaret Maddox

Advertising David Caudill

ADVERTISING: For advertising information, call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in the publication.

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I consider myself a world-class procrastinator. The staff at the Knoxville Academy of Medicine will back me up on this. The KAM’s quarterly newsletter which you hold in your hand was no doubt ready for press days ago but was awaiting my final letter as your President. I’ve just boarded the plane on my last leg back into Knoxville. The unfortunate gentleman in the seat next to me is a bit upset with my tardiness, as well, as my luminescent screen is clearly interfering with his napping plans! Seeking inspiration, I finished up the book I had purchased at the airport newsstand on my trip out, When Breath Becomes Air, by Paul Kalanithi. If you have not yet had the opportunity, I suggest that you check out this great read which really brings home our role as physicians in helping patients deal with their mortality. It also serves as a stimulus to self-reflection causing the reader to consider his own mortality and the type of legacy one wants to leave behind. All of us need the occasional reminder of what really called us to be physicians. In today’s climate of organized medicine with its time demands, reimbursement worries and professional degradation, it is easy to lose the altruistic spirit we all had as students and residents. It is this spirit that I have been witness to over the past two years. As the President of the Knoxville Academy of Medicine, I have had the opportunity to work with some incredible physicians who have selflessly devoted their time and energies to better the health of our community. The result of this labor is no better seen than in the Knoxville Area Project Access which serves as a shining example of physicians banding together to help those patients left behind by a confusing network of healthcare agencies. My thanks to all of our KAPA physicians for your volunteerism. I also thank our membership at large for your continued support when so many other organizations compete for your time and monies. I have had the privilege of mentorship from several of the Past Presidents of our Academy. I was warned that time would pass quickly making projects difficult to conclude. I have no excuse, however, as I have had two years to accomplish my wish list! I

KAM

KNOXVILLE ACADEMY OF MEDICINE want to thank all of the physicians, community leaders and staff that continue to support the Foundation’s IVDA-related endocarditis project. This work has also reinforced the compassionate spirit our members have for a easily dismissed group of affected patients. I look forward to our continued work together. As my time as President of the Knoxville Academy of Medicine draws to a close, I especially want to thank our wonderful staff for giving me their help and direction these past two years. The Academy has continued to grow both in numbers and in outreach as a direct result of their hard work. 0ur incoming President, Dr. Neil Coleman, will enjoy tremendous support as we strive to achieve even bigger goals in 2017!

Tommy

Calendar of Events JANUARY President’s Bash, The Foundry, 6:30 pm 27 Induction of Neil Coleman, MD 2017-18

FEBRUARY Night with the Ice Bears, Civic Coliseum 24 7:30 pm

Doc Rock, NV Nightclub, 7:30 pm

MARCH PITCH 2017, Legislative Plaza, Nashville, 7

Bus leaves at 8:30 am from Sears West Town

APRIL 2017 KAPA’S BOOT SCOOTIN’ BALL 7

Knoxville Marriott, 6:30 pm - 11:00 pm Charlie Daniels Band, tickets on sale now!

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ACADEMY NEWS New Members A big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine. KATHERINE BELLMORE, MD

TODD NICKLOES, DO

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REAGAN BOLLIG, MD

CARRIE POLIN, MD

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RONALD HAMRICK, MD

JUSTIN W. QUINN, MD

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MICAH HATCH, MD

ADAM ROTH, MD

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MATTHEW ISON, MD

LOU SMITH, MD

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BRANDON LANCASTER, MD

MARTHA J. SMITH, MD

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CATHERINE MCKNIGHT, MD

JOHN D. TOWLE, MD

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PHILIP MEYETTE, MD

STEPHANIE VANTERPOOL, MD

FAMILY MEDICINE Summit Medical 103 Midlake Dr Knoxville, TN 37918

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KNOXVILLE ACADEMY OF MEDICINE No Picture Available

GENERAL SURGERY University General Surgeons 1932 Alcoa Hwy Ste 270 Knoxville, TN 37920

DERMATOLOGY Dermatology of Knoxville 939 E. Emerald Ave Ste 705 Knoxville, TN 37920

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy - U109 Knoxville, TN 37920

FAMILY MEDICINE Summit Medical Group 2240 Sutherland Ave Ste 103 Knoxville, TN 37919

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KNOXVILLE ACADEMY OF MEDICINE

GENERAL SURGERY University General Surgeons 1932 Alcoa Hwy Ste 270 Knoxville, TN 37920

TRAUMA SURGERY University General Surgeons 1932 Alcoa Hwy Ste 270 Knoxville, TN 37920

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy - U109 Knoxville, TN 37920

FAMILY MEDICINE Fountain City Family Physicians 103 Midlake Dr. Knoxville, TN 37918

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy - U109 Knoxville, TN 37920

CRITICAL CARE SURGERY University General Surgeons 1932 Alcoa Hwy Ste 270 Knoxville, TN 37920

ANESTHESIOLOGY Pain Consultants of East Tennessee 1128 E. Weisgarber Rd. Ste 100 Knoxville, TN 37909

RADIOLOGY Abercrombie Radiological Consultants, Inc 1112 Weisgarber Rd Knoxville, TN 37909

No Picture Available

Left Column Top to Bottom: Katherine Bellmore, MD; Regan Bollig, MD; Ronald Hamrick, MD; Micah Hatch, MD; Matthew Ison, MD; Brandon Lancaster, MD

FAMILY MEDICINE Statcare Hospitalist 2240 Sutherland Ave Ste 104 Knoxville, TN 37919 ________________________________________________

Center Column Top to Bottom: Catherine McKnight, MD; Philip Meyette, MD; James Morse, MD; Todd Nickloes, DO; Carrie Polin, MD; Justin W. Quinn, MD Right Column Top to Bottom: Adam Roth, MD; Lou Smith, MD; Martha J. Smith, MD; John D. Towie, MD; Stephanie Vanterpool, MD

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JAMES MORSE, MD

FAMILY MEDICINE Summit Medical Group at Parkwest 9303 Parkwest Blvd Ste 100 Knoxville, TN 37923

ANESTHESIOLOGY University Anesthesiologists 1924 Alcoa Hwy - U109 Knoxville, TN 37920

ACADEMY NEWS Annual Legislative Dinner a Success!

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On November 9, the KAM held its Annual Legislative Dinner for legislators from Knox, Blount, Roane, Anderson and Loudon County. This event gives physician members an opportunity to talk with lawmakers regarding issues important to the medical profession and community health in the State of Tennessee. Lobbyists from the Tennessee Medical Association were also on hand to help guide the discussion between physicians and legislators. Issues discussed centered around scope of practice, the future of the ACA and Medicaid expansion in Tennessee in light of the recent presidential election, maintenance of certification (MOC), and balanced billing, just to name a few. Approximately 80 people were in attendance. If you were unable to attend this yearâ&#x20AC;&#x2122;s event, be sure and attend next year! This event continues to be one of the most important annual functions of KAM membership.

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ACADEMY NEWS Legislative Update By: Elise Denneny, MD

Dear Colleagues, As we say goodbye to 2016 and prepare for 2017 let me say thank you to each of you who have given feedback, reached out to their legislators and took the time to take action. It is only though your efforts that we prevail for our patients. With that in mind I would like to place three issues on your radar for 2017. Scope of Practice issues will be deliberated by the Tennessee House and Senate for 2017. One that was introduced three years ago by the Tennessee Nursing Association, it pushes for nurse independent practice. Last year the bill was sponsored by Senator Massey but at the end of the 2016 legislative session there was no vote and the bill was assigned to a task force study. The nurses maintain independent practice will solve the problem of access to care. TMA has countered with the concept of a team-based, physician-led model similar to many models already in place at hospitals and Accountable Care Organizations (ACO). The task force met twice over the summer. TMA presented concerns over the adequacy of training and evidence that the top opioid over-prescribers are nurse practitioners increasing the overall cost of care. TMA’s testimony was met by repeated interruptions from TNA representatives which professionally was akin to a “hostile witness”. TMA submitted a compromise collaborative practice model solution which was summarily shared with the TNA. The TNA has yet to submit their proposed solution to the TMA. TMA will continue to fight for access to quality care for all Tennesseans in 2017. Balanced Billing is a problem that our profession needs to solve. Narrow networks formed by health insurance payors have created the common

problem of patients caught in the middle, when services provided in one hospital may have been treated by a provider out of network. TMA is attempting to find a solution all parties can live with. At present, the issue has been studied by the House Commerce Committee and medical subspecialties were invited to comment. At the time of this publication, the possibility of a mediation process modeled after a proven effective model in Texas is under consideration. All are invited to solve this polynomial equation. Maintenance of Certification (MOC). Oklahoma recently became the first state to decouple MOC as a requirement for licensure, employment or hospital privileges. Kentucky prohibited MOC as a condition of licensure. Mounting evidence that many MOC programs under the ABMS are financially self-serving academicians which does nothing to improve quality is becoming apparent. Many MOC specialty programs are both costly and time consuming with no thought in their creation to the already existing specialty CME programs. Many physicians are obliged to participate because board certification is a prerequisite for continued hospital staff status and employment. The promotion of life-long learning is an honorable quest not to be exploited by a society’s need for revenue. TMA is soliciting your comments on your MOC. Please send comments to rebecca.lofty@ tnmed.org. As I close out the year, may I again express thanks to all of you who care for patients despite the waves of EHR, insurance, MACRA/MIPS, Tennessee Health payment reform and every other exogenous doltish, ignorant intrusion into the practice of good medicine. Thank you for your intellectual curiosity, compassion and good humor which prevail through exhausting hours of call. You are heroes! Happy Holidays. Elise

Warmest Wishes for a Happy Holiday 6

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ACADEMY NEWS Keeneland - A Day at the Races!

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And they’re off… Physician members from the Knoxville Academy of Medicine, Blount County Medical Society and Roane-Anderson County Medical Society along with their invited guests boarded the chartered bus and headed for a fun filled day at Keeneland horsetrack in Lexington Kentucky. New this year, physicians had the opportunity to earn 1 hour of CME on the way to the track compliments of KAM and TMA. The CME speaker was Dale Amburn, JD, with London and Amburn, who presented valuable insights on practicing options as well as careful considerations in selling a practice. Horse enthusiasts and first time attendees had a fabulous day of great food, fellowship and entertainment. This year’s visit included a private dining area overlooking the paddock, private betting windows, as well as grandstand reserved seats. Special thanks to Capital Finance for their sponsorship of this event. Be sure to check out the Calendar of Events at knoxvillemedicine.org often to stay current on all the up coming events.

LMU-DeBusk College of Medicine Hospital Day LMU-DeBusk College of Medicine held their Annual Hospital Day in October. This event was largely attended and provided students with a wealth of resources as they anxiously explored clinical training opportunities and spoke with organizations representing the medical field. Knoxville Academy of Medicine staff was also on hand to discuss the benefits of participation in organized medicine. Many of the students there will now do clinical rotations at some point in Knoxville, so the KAM has extended student memberships in both the Knoxville Academy of Medicine and the Tennessee Medical Association. Staff was able to sign up more than 250 students in a three hour period for membership. In November, the AMA-MSS (American Medical Association – Medical Student Section) chapter was officially recognized. Watch for updates on this growing group as we welcome additional students!

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ACADEMY NEWS

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Resident Article

Physician Advocacy – Shaping the Future of Medicine By: Patrick McFarland, MD PGY3 (Third Post-graduate Year) AN Resident UT Graduate School of Medicine, Dept. of Medicine Medicine is evolving more than ever before and physician advocacy is becoming an increasingly valuable tool for organized medicine. Despite all of the rhetoric during this past political season, change appears to be the only constant in politics, particularly regarding healthcare. To ensure the best for our patients, we as physicians must maintain a guiding hand in this process. Physician advocacy is this guiding hand and ensures policymakers are advised by those who know medicine best. In other words, physician advocacy is organized medicine’s best tool in shaping the future of medicine. To say the legislative process is intricate would be an understatement. In my first post-graduate year of training, I had the privilege of gaining first-hand experience of these intricacies and how they affect healthcare policy during a legislative session while in our nation’s capitol. I quickly realized the importance of this learning opportunity. I learned what it means to be a physician advocate and how we, as physicians, can positively affect change on a national level. A physician advocate speaks as an expert in the medical field and advises legislators on the details and potential consequences of certain legislation. Without physician advocacy, legislators would not only be making decisions blindly, but they would be making decisions with input from only one perspective. Unfortunately, not all perspectives have the patient as the priority.

Although healthcare policy seems to revolve around Washington D.C., the impact of physician advocacy at the state and local level must not be neglected. It could be argued state and local advocacy is just as important, if not more so, than advocacy at the national level. I was fortunate to have the opportunity to visit our state’s capitol this year to observe the state legislative process and employ my newly learned skills as a physician advocate. Yet again, I realized the importance of this process; however, this time there was something slightly different. At the state level, healthcare issues appeared more malleable and the results of physician advocacy seemed more readily apparent. We were driving change in real time, regarding issues that affected physician practice day-to-day. Despite the value of this experience, only one other resident in the state participated in this event. Physician advocacy begins in residency and we must emphasize its significance during our training. To achieve this aim, the Tennessee Medical Association is developing an Advocacy Training Program which would allow medical students and residents to gain vital experience in the field of physician advocacy. Participants would receive recognition for engaging in certain activities, such as visiting the Tennessee Capitol during the legislative session, contacting legislators to express support for or opposition to upcoming healthcare bills, or volunteering in fundraising events for TMA’s political action committee. This program is the first step in learning how to become an effective physician advocate and I encourage all to participate, as we continue to shape the future of medicine.

Essential Oil Holiday Scents It’s beginning to smell a lot like Christmas! Here are seven aromatic recipes to add in your essential oils diffuser this winter season. Note: Depending on the size of your room and the type of diffuser you have, amounts may vary.

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TECHNOLOGY NEWS More than 125 million patient records available on demand by: Leigh Sterling Executive Director East Tennessee Health Information Network Electronic health information exchange through East Tennessee Health Information Network (etHIN), this region’s Health Information Exchange, is more robust than ever. The upgraded etHIN Health Information Portal (eHIP) with new features is now available, and increasing community participation has made the probability of finding useful data about your patients through etHIN more likely than ever before. etHIN currently receives patient data from local hospitals, physician practices, reference labs, and imaging centers. They have provided more than 125 million patient records to etHIN, which makes the data available on-demand to authorized healthcare provider users treating shared patients. Those records represent almost 1.8 million patients living, working, and vacationing in East Tennessee. Information available through etHIN includes patient hospital admis-

sion and discharge summaries, lab results, transcribed reports, radiology summaries, images and more. New features in the enhanced eHIP clinical portal include a Potential Gaps in Care list and natural language processing, which normalizes unstructured data in transcribed reports and other narrative documents, providing fast, thorough searches. As more providers in the healthcare community learn about etHIN, the number of data providers continues to increase. Data connection implementations are currently in process with several physicians’ groups and labs, and onboarding discussions are underway with numerous other healthcare organizations in etHIN’s region. Connecting to etHIN can provide up-to-date, real-time patient information from other participating providers, allowing you to provide more coordinated patient care. Other benefits may include reduced administrative costs associated with gathering patient information, as well as avoiding duplicate lab and radiology costs for your practice. For providers affected by MACRA, participating in ACO’s, or other risk-sharing payment models, using etHIN’s services may also help achieve some of your goals, including care coordination, quality, and cost reduction. Learn more about etHIN at www.ethin.org, or call us at 865691-8433.

Shelley Dye Schaad Residential Real Estate This beautiful gated European estate has every detail covered and is located on five pristine acres only a minute's drive from Lakeshore Park. Designed by renowned architect Keith Summerour, this home features Ludowici roof tiles, three French Rumsford fireplaces, Crittal windows and doors, and reclaimed white oak floors. The gorgeous kitchen has a LaCornue Range, thick solid soapstone countertops and sub-zero refrigerators. The adjoining butler's pantry is perfect for entertaining guests. The master bathroom features an elegant marble soaking tub overlooking a private courtyard and large custom closets. Custom hardware by E.R. Butler & Co. and Waterworks plumbing fixtures. The spacious walkout basement includes plenty of living space, lots of natural light and a wine cellar. The entire home is equipped with Crestron Electronics, and the beautiful grounds are designed by landscape architect John Howard. The perfect setting in an ideal location! Please Contact: Shelley Dye Schaad Residential Real Estate (865) 202-7878 sdye@schaadcompanies.com

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LEGAL NEWS HIPAA: Time to Get Your Head in the Cloud Sunshine Act of 2010 By: Ian P. Hennessey, Esq., London Amburn, P.C.

Recent years have witnessed the rise and growing popularity of cloud computing services. Web applications like Google Drive, iCloud, and DropBox (just to name a few) have made sharing information easier than ever before. But while these developments may be welcome in terms of technological advancement, the use of cloud computing services raises potential compliance issues under HIPAA. The “cloud” and “cloud computing” are relatively recent entrants into our lexicon. So what is it, exactly? The technical definition of cloud computing is “a model for enabling ubiquitous, convenient, ondemand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction.” Put more simply, cloud computing means storing and accessing data and programs over the internet instead of your computer’s hard drive. Cloud computing is permitted under HIPAA, but with some very important caveats. When a covered entity (as defined under HIPAA) engages another cloud computing service provider (“CSP”) to create, receive, maintain, or transmit electronic protected health information (“ePHI”), such as to process or store ePHI, on its behalf, then such CSP is a business associate as defined under HIPAA. By the same principle, when a business associate subcontracts with a CSP to create, receive, maintain, or transmit ePHI on its behalf, the CSP subcontractor itself becomes a business associate. Moreover, the CSP is a business associate even if the CSP stores only encrypted ePHI and does not have an

Blount County Medical Society Quarterly Update By: Jerome Heiny, MD

As winter approaches, I reflect on the past year with what we have accomplished and so much more yet to come. I have enjoyed the opportunity to serve as the president of the Blount County Medical Society for the past year. This year we have welcomed several new members, and I look forward to our medical society continuing to grow in future years. I had the opportunity to attend the annual Doctors Day on the Hill and meet with some of our area legislators to discuss issues important to us as physicians. Day on the Hill is a free event for members and includes chartered bus transportation to Nashville. I would encourage all to sign up for next year’s event by going to the TMA website at TNMed.org and completing the registration for March 7, 2017. This event is sponsored by TMA and KAM and is greatly appreciated along with all the work they do on our behalf. This past August we held our first picnic for members and their

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encryption key to access the data. If a CSP is a business associate, then the covered entity (or business associate, as the case may be) and the CSP must enter into a HIPAA-compliant business associate agreement. If a covered entity (or business associate) uses a CSP to process or store ePHI without entering into a business associate agreement with the CSP, the covered entity is in violation of the HIPAA Rules. For instance, in a recent enforcement action, HHS Office of Civil Rights obtained a $2.7 million settlement from Oregon Health & Science University due (in part) to its storage of the ePHI of over 3,000 individuals on a cloudbased server without a business associate agreement. Technology continues to develop and advance at a rapid pace and so too the relative ease of sharing, storing, and transmitting data, including protected health information. Amid these changes, the message from HHS has been constant: covered entities (and business associates) must comply with HIPAA. In the current enforcement environment, including ongoing, random HIPAA audits, health care providers that ignore HHS’ message may be placing their practice at serious legal and financial risk. Ian P. Hennessey is an attorney with London Amburn, a law firm based in Knoxville, Tennessee, which represents providers in the area of healthcare law, including regulatory, compliance, HIPAA, malpractice and nursing home defense, employment, mergers and acquisitions, corporate and business matters. For more information, you may contact Mr. Hennessey at (865) 637-0203 or visit www.londonamburn.com. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.

families. While it was lightly attended, hopefully, we can continue and expand this in the future. It was a great opportunity to socialize with one another during a family friendly event. In November, my wife and I had the pleasure of attending the legislative dinner with the Knoxville Academy of Medicine and Roane-Anderson County Medical Society. This event was also free to members and was a wealth of information regarding legislative issues that will be points of discussion in the near future. Many of these issues were of interest to all of us in Tennessee and I hope that next year you take advantage of this great member benefit. On December 3rd, BCMS members are invited to attend the KAM CME Saturday Blitz where up to 4 hours of CME will be offered at no cost to members. This CME event includes a 2 hour prescribing practices requirement. The event will be held at The University of Tennessee Medical Center. Be sure to register at knoxvillemedicine.org to reserve your spot. Finally, I look forward to our annual Christmas dinner which will be held on December 13 @ 6:30 pm at the Royal Oaks Country Club, I hope to see all of you there.

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FINANCIAL NEWS 5 Reasons to Refinance Your Student Loans in 2016 by John Arnold Executive Chairman, SouthEast Bank

2016 is proving to be one of the most opportune times to refinance student loans. To explain why, the experts in student loan refinancing and debt consolidation at ELFI have compiled the top five reasons why borrowers should take advantage of current interest rates and refinance their student loans as soon as possible: Reduced Interest Rates - Current interest rates for student loans may be much lower than when the loan was opened. Therefore, refinancing while rates are low can result in qualified borrowers paying less in interest each month and over the life of their loan. Borrowers should take advantage of lower, more desirable rates while they are offered, as they could change — and rise — at any time. Lower Monthly Payments - Modifying the repayment term of a student loan by extending the years of repayment may allow borrowers to enjoy lower monthly payments. For instance, if a borrower has already paid five years of a ten-year repayment term, he or she may be able to refinance the outstanding amount to ten or fifteen more years, thereby lowering their monthly payment amount. Borrowers should, however, avoid the temptation to extend the term too much, as longer terms generally increase the overall cost of the loan. Make sure to assess each plan and figure out what

makes the best financial sense — right now and in the future. Benefits Associated with Removing the Co-Signer - Refinancing student loans may allow borrowers to release any co-signers from the loan — an action that can be beneficial to both parties. For co-signers, this releases them from future financial responsibility to that loan, and it may also assist them in improving their own financial profile by reducing the amount of debt in their name. Easy-To-Manage Accounts - When multiple student loans are refinanced with refinancing institutions such as ELFI, the loans are consolidated into one, easy-to-manage loan. This helps borrowers eliminate any confusion related to having multiple balances, due dates, and payment amounts. Gain a Financial Advocate - Just as in any industry, the level of customer service among banks and lenders varies from one company to another. When considering refinancing with any lending institution, borrowers should research and compare each company’s ability to help customers with any issues. In order to maintain a happy, working relationship, borrowers should speak with a representative to find a company that is informative, dependable, friendly, and flexible. Medical professionals work hard to obtain their college and professional degrees. The personal loan advisors at ELFI specialize in student loans and provide borrowers, particularly those in the healthcare fields, with information to help determine the best solution for their budgets. The sooner borrowers begin to assess their loans and find a smarter plan, the more money they can save right now — and in the future.

(865) 859-7010 www.thefirstladyshop.com Open Monday - Friday 9:00am - 4:00pm and by appointment after hours Located in the Cancer Center at North Knoxville Medical Center

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HOLIDAY RECIPES FROM KAMA

KAM KNOXVILLE ACADEMY OF MEDICINE

Cherry Almond Cake

Submitted by: Brenda Mask (Spouse of Dr. Charles Stone Mitchell) Ingredients: 2 1/2 cups cake flour 1 1/2 cups white sugar 3 teaspoons baking powder 1/2 teaspoon salt 1/2 cup butter, softened 1/2 cup milk 1/4 cup maraschino cherry juice 16 maraschino cherries, finely chopped 4 large egg whites, beaten

Buttercream: 4 sticks butter, softened 8 cups powdered sugar 4 Tablespoons maraschino cherry juice 4 Tablespoons heavy cream 1 teaspoon almond extract few drops of red food coloring, optional For decorating: Maraschino cherries, drained and dried Sliced almonds

Cake Instructions: 1. Sift together the cake flour, sugar, baking powder and salt into the bowl of a stand mixer. Add the softened butter, milk and cherry juice. Beat on medium speed for 2 minutes. Fold in the chopped cherries. 2. Whip egg whites until stiff, and fold into above and beat for an additional 2 minutes. 3. Spray three 7” baking pans with baking spray. Divide the batter between the cake pans. 4. Bake at 350’ for 20-30 minutes, or until the cake springs back when you touch the center of it. 5. Allow the cakes to sit for 5 minutes, the remove them from the pans to a wire rack to cool completely. Frosting Instructions: 6. In a stand mixer bowl, with the mixer on medium speed, whip the butter for 2-3 minutes until it is almost white in color. Add in the powdered sugar, cherry juice, heavy cream and almond extract. Add a drop or two of red food coloring if you’d like the cake to be a little pinker. Beat on low speed again for 2-3 minutes. 7. Once the cakes are cool, place one cake on a cake plate. Put a layer of frosting, then add next layer, then another layer of frosting. Lastly add third layer. Using a knife, spread frosting on the top and sides of the cake, covering it completely and getting the frosting as smooth as possible. Decorating: 8. Using the Wilton tip #21 decorate with buttercream and pipe simple stars around the bottom and top edges of the cake. 9. Place the drained and paper towel dried maraschino cherries on the top of the cake in a placement that you would like. Place almond slices around the cherry, sticking them into the buttercream so they look like flower petals around the cherry. Adapted from: http://www.tastesoflizzyt.com/2015/01/30/cherry-almond-cake/ 10. Refrigerate the cake until serving.

Golden Cheddar Soup Submitted by: Michele M. Carringer Knox County Commissioner Ingredients: 3 cup water 1/2 cup flour 3/4 tsp. salt 1/2 cup butter 1/4 tsp. pepper 4 cups milk 2 cups celery 4 cups sharp cheddar cheese 2 cups carrots 2 cups diced ham 1/2 cup diced onion 4-5 diced potatoes

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Combine water, vegetables, salt and pepper in a 6 qt. pan and bring to boil and reduce heat. Cover and simmer until tender. Use another 6 qt. pan and melt butter and add flour until blended and gradually add milk. Cook over medium heat stirring constantly till thicken. Remove from heat and add cheese. Stir until melted. Then add ham. Add milk mixture to vegetables and heat. Do Not Boil!!! Serves 12

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KAMA CORNER By: Barbara J. Crist KAMA President, 2016-2017 Fashiondrama was a successful evening event held on October 16th at the Knoxville Museum of Art and will be repeated in future years. It’s been a luncheon for 62 years, which was a big change for KAMA. The band and fashions were impressive, and the environment was elegant. Thanks to chair Jennifer Ollis and her fashion drama committee for pulling it off! This year’s profit of just under $24,000 was higher than last year’s! Knoxville’s Medication Take Back Day was October 29th, KAMA contributed by spreading Metro Drug Coalition (MDC) flyers throughout the community. Expired medications can always be dropped off at the KPD Safety Building downtown or at the drop box at Walgreens at 121 N. Northshore Dr. Generation Found, a KAMA sponsored film screening, will be shown January 19th, followed by a question and answer period conducted by Karen Pershing, Director of the MDC. The film is about the development in Houston of a system of sober recovery high schools combined with alternative peer groups, treatment centers, as well as collegiate recovery programs. There are currently 36 of these recovery high school programs throughout the USA, including one in Nashville. KAM members and spouses are invited. KAMA members read the Dreamland book in preparation for a book discussion held October 20th to spread awareness regarding issues with the opioid epidemic. Members and guests were able to participate in a live Skype Q&A session with author Sam Quinones.

Doc Rock will be on February 27, 2017 at NV night club in the Old City! Doc Rock is our next fundraiser with proceeds benefiting local health-related charitable organizations. VIP and regular tickets will be available after January 1st. This event features great music played by bands that include local physicians. The upstairs VIP area offers its own bar, complimentary food, and a less crowded atmosphere. KAM members and spouses are invited! Healthline, a 30 year KAMA project chaired and hosted by Sheila Wittke, is a weekly CTV Community Television show featuring interviews with area physicians on current topics, procedures, and illnesses. Sheila and her crew members are retiring at the end of this year. We are currently strategizing to determine options and future directions. TMAA Fall Update was held November 6-7 in Monteagle, TN with good county representation, including nine from KAMA. Time was spent on development of methods to strengthen TMAA’s role for future years. KAMA Meeting recap: October featured Mayor Tim Burchett, November’s speaker was Captain Parrott of Knoxville Homeland Security and December will be a social event. KAMA is an organization of local physician spouses committed to improving the health of our community and supporting the family of medicine through service, philanthropy, and friendship. Meetings are held monthly on the first Thursday of each month and new members are welcome! There are many opportunities to get involved and if you would like to learn more, please visit us on Facebook (Knoxville Academy of Medicine Alliance) and on our website (www.kamalliance.org).

2016 Fashiondrama

| KNOXVILLE MED CINE

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